Insurers Need Not Prove Fraud To Deny No-Fault Payments To Healthcare Providers, New York Court Of Appeals Decides

After insurance companies stopped paying no-fault claims submitted by Andrew Carothers, M.D., P.C., a professional service corporation, as assignee, the PC sued the insurers. The insurers asserted that, under State Farm Mut. Auto. Ins. Co. v. Mallela,

Maybe you feel that the title to this bulletin is “immoral” or “scandalous,” or maybe you don’t.  Either way, in light of the U.S. Supreme Court’s recent decision in Iancu v. Brunetti, whether a word or term is “immoral” or “scandalous” is no longer relevant to whether that word or term can receive federal trademark

5th Circuit Applies Deferential Abuse-of-Discretion Standard of Review and Upholds Claim Administrator’s Application of Plan’s Weight-Loss Surgery Exclusion

The U.S. Court of Appeals for the Fifth Circuit has upheld the adverse benefit determination of a claim administrator of a health insurance benefits plan governed by the Employee Retirement Income Security Act of 1974 (ERISA) after

Commentary:

Dustin and Brooks have owned a business together for years. They have no agreement. Dustin wants to retire and work on his golf handicap. Brooks wants to keep working and expand the business. They agree that Brooks will buy Dustin’s interest in the business.

They get together with Rory, the company accountant, and they

Our June insurance update is now available.  Packed with cases, our update touches upon a variety of issues.

We start off with two state high court decisions.  One deals with faulty work, the other considers whether a third-party claims administrator must answer to a claim for bad faith.

Sticking with bad faith, a Delaware court

A plethora of federal laws address the proliferation of technology-enabled automated communications in a variety of areas, including finance, commerce, credit, and health. Although the general objective is to address individual privacy and data security concerns, each law contains distinct goals, technical requirements, and remedies if violated. One issue that continues to evolve is whether

It goes without saying that cybercrime is a growing concern. In April, the FBI released its annual IC3 (Internet Crime Complaint Center) Report, which showed that the FBI received over 350,000 cyber-crime complaints in 2018, with total losses of over $2.7 billion.

One common type of cyber crime is spoofing, which is the cyber version

On June 3, 2019, the United States Supreme Court ruled that Title VII’s charge-filing requirements, while mandatory, are not jurisdictional, and any objections will be deemed forfeited if an employer waits too long to raise them.

In Fort Bend County, Texas v. Davis, Respondent Davis filed a charge against her employer, Fort Bend County, with

Stuart Gordon’s and Matthew Spero’s article, “Marijuana Businesses in Bankruptcy: Courts Just Say No,” was published in the May 2019 issue of the Pratt’s Journal of Bankruptcy Law.

Click here to read the article.

Third Department Affirms Dismissal Of Coverage Case Filed More Than 24 Months After Loss

After a building in the city of Troy was burglarized, the building owner sought coverage for the damage.  On September 18, 2014, the insurer denied the claim because of the policy’s lack of coverage for theft and water damage.  On October

Second Circuit Finds That Claim for ERISA Pension Plan Benefits Was Time-Barred

Historically, employees leaving Xerox Corporation typically received a lump sum payment equal to the total value of their then-accrued pension benefit under the Xerox pension plan, an employee benefit plan governed by the Employee Retirement Income Security Act of 1974 (ERISA). Employees who

Trademark licensees no longer need to fear the possibility of losing the right to use their licensed marks if the licensor files for bankruptcy. On May 20, the United States Supreme Court issued its decision in Mission Product Holdings, Inc. v. Tempnology, LLC nka Old Cold LLC, 587 U.S. __ (2019), holding that a licensor’s

My friends who own boats often share with me the famous adage that the best two days of boat ownership are the day that the boat is purchased and the day the boat is sold. The joys of boat ownership are quickly subsumed by the day-to-day grind of maintenance and other aggravations that come with

Just like the abundance of rain we’ve had so far this spring, we’ve seen a recent downpour of coverage disputes. And just like the April showers that brought us May flowers, those coverage disputes have now blossomed into some interesting decisions. Our May Insurance Update discusses some of the best picks:

• The insured sells

Sixth Circuit Affirms District Court Decision That Anesthesiologist Was Not Disabled from His Own Occupation

The U.S. Court of Appeals for the Sixth Circuit recently affirmed a district court’s decision upholding a determination by the claim administrator of an employee welfare benefit plan governed by the Employee Retirement Income Security Act of 1974 (ERISA) that